China sex worker crackdowns hamper progress on HIV prevention

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Prostitution in the People’s Republic of China has been growing since the opening up of the country in the 1980s, when controls were relaxed and society became more affluent. The ‘oldest profession in the world’ is often carried out in shops that advertise themselves as barbers and massage parlors, or in parks and hotels.

The government has made heavy-handed efforts to crack down on the phenomenon. According to China’s national news agency Xinhua, in 2010 the Ministry of Public Security sent 27 groups of inspectors to 651 entertainment business venues in four municipalities and 20 provinces, uncovering cases of prostitution in about 381 places. Another campaign took off in 2012 and according to China Daily, 48 entertainment venues in Beijing were shut down. These interventions were not the only ones undertaken by Beijing and surely they are not going to be the last.

Pic: AP.

The government has usually deemed its policies successful, but on May 14 Human Rights Watch (HRW) slammed Beijing’s policies arguing that they carried out serious abuses on sex workers. The group argued that “sex workers are most at risk of abuses such as police brutality and arbitrary detention during these drives,” and provided a long list of cases.

It is also unclear whether these campaigns are any help in dealing with the rise of HIV infection in China. A research about China published by the Oxford Journal’s International Journal of Epidemiology points out that crackdowns in China are “a contentious approach since it focuses on punishment rather than on education.”

In its paper, HRW said that during crackdowns many of the women detained were tested for HIV/AIDS, but it reported significant flaws in the process, including the disclosure of tests results to third parties or the non-disclosure of the results at all – not even to the patients. One of the women interviewed by HRW lamented that she had been tested the year before but was never given any information concerning her situation.

Aggressive behavior toward sex workers can also reduce their willingness to take health check-ups, if they perceive a risk of mistreatments. “I don’t go to those clinics anymore. They were really disdainful of me when I went last time. Also, I was scared they would report me to the police,” a girl reportedly told HRW. Avert, an international HIV charity, wrote on its website that “it is feared that reaching sex workers, and sex workers who use drugs, with HIV prevention may be hindered by government crackdowns.”

This is no small issue, especially as according to a research by the Joint United Nations Programme on HIV/AIDS (UNAIDS), sexual transmission of HIV is the single largest cause of new infections in the country: of the 780,000 people estimated to be living with HIV in China in 2011, 46.5 per cent had been infected through heterosexual transmission.

Prostitution is commonly believed to be an underlying factor in these dynamics. In 2012, China Daily reported that according to official statistics HIV is increasingly prevalent among people over 60 years old, presumably because of unsafe sex. The paper quoted official statistics as saying that 483 new HIV carriers aged over 60 were diagnosed in 2005, accounting for 2.2 percent of the total that year. In 2010, the number had surged to 3,031, nearly 9 percent of total new infections.

In the past decade, the government’s efforts to reduce risks posed by infections have been ongoing. According to the mentioned UNAIDS report, “data from national sentinel surveillance sites shows that coverage of sex workers increased from 74.3 per cent in 2009 to 81.0 cent in 2011; the percentage who received at least one HIV testing during the past 12 months and received their result increased from 36.9 per cent to 38.2 per cent; the percentage using a condom during the last sex act increased from 85.1 per cent to 87.5 cent.” China has also “continued to strengthen its HIV testing network, improving testing capacities.” When looking at these apparently successful policies, it truly seems a sad irony that the fight against HIV should be hampered by the crackdowns on prostitution.

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